Ayushman Card 2026: Eligibility Rules, ₹5 Lakh Benefits and Steps To Apply Online

The Ayushman Card under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana gives cashless hospital care worth up to Rs. 5 lakh per family each year. It covers listed secondary and tertiary treatments at enrolled government and private hospitals across India, helping low-income households access treatment without paying at the hospital counter.

From 11 September 2024, senior citizens aged 70 years and above receive an extra Rs. 5 lakh health cover every year, separate from the family limit. All ages in an eligible household are covered, pre-existing illnesses are included from the first day, and registration is based mainly on Socio-Economic Caste Census 2011 data.

Ayushman Card eligibility and coverage under PMJAY

The Ayushman Card is linked to the Ayushman Bharat Health Account, which stores health records and identity details for beneficiaries. Under PMJAY, each eligible family receives up to Rs. 5 lakh of cashless and paperless hospitalisation benefits every policy year, specifically for approved secondary and tertiary level procedures in empanelled hospitals.

There is no specific income ceiling mentioned for Ayushman Card access. Instead, eligibility depends on whether a rural or urban household appears in the SECC 2011 list or falls within updated categories such as Accredited Social Health Activist (ASHA), Anganwadi and other welfare workers added from 2024, along with defined vulnerable groups.

Ayushman Card eligibility categories for rural and urban households

In cities and towns, Ayushman Card eligibility focuses on informal and low-paid workers. These include ragpickers, beggars, domestic workers, street vendors, hawkers, cobblers and other street-based service providers. Construction workers, masons, plumbers, welders, painters, labourers, security guards and other head-load workers are also part of the identified urban groups.

Further, sweepers, sanitation staff and malis are listed, along with home-based workers, handicraft workers, artisans and tailors. Transport staff such as conductors, drivers, cart pullers, rickshaw pullers, and helpers to drivers and conductors are included. Assistants, shop staff, peons in small establishments, delivery workers, helpers, waiters, attendants, electricians, assemblers, mechanics, repair workers, washermen and chowkidars are also considered eligible urban households.

In rural areas, Ayushman Card coverage targets vulnerable families based on housing conditions and family composition. Eligible groups include households living in one-room kucha houses, families without any adult member aged 16-59 years and Scheduled Caste or Scheduled Tribe households. Families with a disabled member and no non-disabled adult, and households without an adult male member aged 16-59 years also qualify.

Landless rural families depending on manual casual labour are explicitly recognised for Ayushman Card benefits. All eligible household members, regardless of age, can be covered under the family entitlement of Rs. 5 lakh annually. The scheme aims to capture the poorest and most insecure workers in both village and city settings through these SECC 2011 categories.

Ayushman Card benefits, coverage limits and exclusions

Through the Ayushman Card, each eligible family can access cashless treatment between Rs. 30,000 and Rs. 5,00,000 every year, depending on the package. Around 1,929 medical and surgical procedures are covered, including operations, intensive care, medicines, diagnostic tests, consumables, room rent, surgeon fees, ICU charges and operation theatre services.

Ayushman Card benefits extend to about 24 specialities, ranging from cardiology, neurosurgery and orthopaedics to oncology and other super speciality care. The family can also claim expenses for three days before admission and up to 15 days after discharge, which may include tests, medicines, follow-up visits and related medical needs.

However, the Ayushman Bharat Yojana lists some exclusions. Outpatient department consultations are not covered under the Ayushman Card. Cosmetic surgeries, fertility treatments, organ transplants, individual diagnostics taken outside an admission and drug rehabilitation services are excluded from PMJAY benefits.

Medical packages and hospital costs under Ayushman Card

Ayushman Bharat PMJAY groups treatments into predefined packages, which also apply for Ayushman Card users. These packages include both day-care procedures and surgeries across nearly 24 specialities, covering advanced services like neurosurgery, oncology, cardio-thoracic and cardiovascular surgery along with general specialities.

The package rate for surgical or day-care benefits under the Ayushman Card normally includes registration fees, general ward bed charges, nursing and boarding costs and fees for surgeons, medical practitioners, anaesthetists and consultants. Costs linked to anaesthesia, operation theatre use, blood transfusion, oxygen and surgical appliances are also usually bundled.

Medicines, drugs, pathology tests and radiology investigations under Ayushman Card packages are part of the cover. Investigations may include MRI, X-ray, CT scans and other diagnostic services. Costs of implants and prosthetic devices are included unless mentioned separately, along with other hospital expenses related directly to the approved treatment within empanelled hospitals.

Ayushman Card process for hospitalisation and cashless treatment

To use the Ayushman Card, beneficiaries first need to locate an empanelled hospital in their area. This can be checked online or with assistance from a nearby Common Services Center. On arriving at the hospital, the patient presents the Ayushman Card and identification documents at the reception desk.

The hospital team scans the Ayushman Card QR code to verify beneficiary details on the PMJAY system. Once verification is complete and the condition matches an approved package, the hospital initiates the admission. Treatment for covered procedures is then provided on a cashless basis, meaning the patient does not pay for authorised services.

Ayushman Card age rules, senior citizen top-up and income criteria

The Ayushman Card covers every member in an eligible household, with no minimum or maximum age limit. Children, adults and elderly members all share the family entitlement of Rs. 5 lakh per year, as long as they appear under the approved household list from SECC 2011 or updated worker categories.

Since 11 September 2024, each senior citizen aged 70 years and above can receive a separate Ayushman Vay Vandana Card. This provides an additional Rs. 5 lakh health cover annually, independent of the family’s main Ayushman Card allocation. There is still no fixed income limit for beneficiaries under PMJAY.

Senior citizens already enjoying benefits from public health schemes like Ex-Servicemen Contributory Health Scheme, Central Government Health Scheme or Ayushman Central Armed Police Force can continue with those schemes or move to AB PMJAY. Those holding private health insurance or Employees' State Insurance cover can also receive Ayushman Card benefits.

Step To Get Ayushman Card: Documents and Online Registration

Ayushman Card registration is simple because only one document is usually required. Beneficiaries need a valid Aadhaar number to complete e-KYC and link identity details to the Ayushman Bharat Health Account. No additional documents are demanded at the online enrolment stage for the standard PMJAY Ayushman Card.

To register online, users visit the official pmjay.gov.in website and select the 'Am I Eligible’ option. After entering the captcha, mobile number and OTP, they log in again using a captcha. Next, they choose their state, select the sub-scheme as 'PMJAY’, pick district and search type, then enter the asked details to run an eligibility search.

If the system shows an eligible record, applicants click 'Do e-KYC’. They choose the 'Aadhaar OTP’ option, confirm the visible Aadhaar number, tick the consent box and allow the portal to access details. After entering both Aadhaar OTP and mobile OTP, a message confirms e-KYC completion. After 15-20 minutes, users log back in and use 'Download Card’ to authenticate again and download the Ayushman Card.

Ayushman Vay Vandana Card process for senior citizens 70+ years

Senior citizens above 70 years who qualify can apply online for the Ayushman Vay Vandana Card using the same PMJAY portal. They start by visiting the website, clicking 'Am I Eligible’, entering captcha, mobile number and OTP, then logging in again and choosing the 'Click Here to Enroll’ button on the screen.

Applicants enter the Aadhaar number and captcha, then click 'Search’. They select the 'Click Here for fresh enrollment of 70’ link, choose Aadhaar OTP for e-KYC and click 'Verify’ against the Aadhaar number. After ticking the consent box and allowing access, they submit Aadhaar OTP and mobile OTP, indicate if they receive any other scheme benefits and then press 'Proceed’.

The portal prompts the user to 'Capture Photo’, which is taken and uploaded. Senior citizens then add extra information and family member details before submitting the form. When e-KYC and enrolment finish, they again open the PMJAY website, use 'Click Here to Enroll’, search using Aadhaar and captcha, select their displayed name and choose 'Download Card’ to obtain the Ayushman Vay Vandana Card.

Ayushman Card helpline and overall role in healthcare access

People who face issues with Ayushman Card eligibility, registration or use can contact the official helpline at 14555 for assistance. For specific questions on the Ayushman Vay Vandana scheme for senior citizens aged 70 years and above, beneficiaries can give a missed call to 1800-110-770 and receive guidance.

The Ayushman Card under Ayushman Bharat PMJAY aims to protect economically weaker and vulnerable households from heavy hospital expenses. With cashless cover up to Rs. 5 lakh per family each year and an additional Rs. 5 lakh for each eligible senior citizen aged 70 and above, it helps ensure that people can receive needed treatment at empanelled hospitals without facing direct payment barriers.